BLCK (09208) + RPL (09167) + PAT (09228)44435 Marigold Lane
09208
09167
09228
P.O. BOX 1504~ No.
Building 78-105 CALLE ESTADO -
Address 44-425 Mariaold Lane LA QUINTA, CALIFORNIA 92253
Owner ,- a .:-. _ t
BUILDING: TYPE CONST. OCC: GRP.
Mailing y
Address same A.P. Number
City Zip 77-
Legal
Description
Contractor Project. Description 91• •7 f-rf 6% a h1eick TvrAI I
-Address.
49-125 T ancro Coiiit i
-City Zip Tel
State ic. w. - - City t ::
& Classif. ' ' Lic. # Sq. Ft. No No. Dw.
Arch:, Engr.,
B' C '2,9 5512l 1812 Size Stories': Units
Designer. New ❑ Add ❑;Alter ❑ Repair ❑. ' Demolitiori ❑.
Address Tel.
City Zip State
Lic. # -
LICENSED.CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section `-_ W,
_ 7000)•of.Di•vision 3 of the,Business and Professions Code, and my license is in full force and
effect. '""' "`
1GNATURE DATE -
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor s=License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any'•cfy or county which requires a.
permit to construct, alter, improve, demolish, or repair any structure,. Qrior to its issuance also - ..AMOUNT
a'requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT .- r . •'
the provisions• of the Contractor's License Law, • Chapter 9 (commencing with Section 7000) o/ - ' -
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis - for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. "
' subjects the applicant to a civil penalty o/ not more than five hundred dollars ($500). _ Plan Chk• Bal.
.❑ I, as owner,ofthe property, or.my employees,with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 'p
" Professions Code: The. Contractor's. License Law does not apply to an owner o/ property .who
.builds or improves thereon and _who does such work himself or through his own employees, M@CIi.
_Pro vided.that:such improvements are not intended or offered for
safe'
1/, however,. the building • _ ,
or improvement is sold within one year of completfon, the owner -builder will have ,the burden Electrical -
Cproving.that he did not build or improve../or the purposeo/ sale.) - '
O I, as owner of the property, am exclusively contracting with licensed contractors to con Plumbing
strucI the project. (Sec. 7044, Business and Pro/essions Code:. The Contractor's License Law _
;. does not apply to an
owner o/ property who builds or improves thereon, and who contracts for _ S.M.I.
07
such 'projects with a contractors) licensed pursuant to the Contractor's License Law.) -•
Grading
❑ 1 am exempt under Sec.' B. & P.C. for this reason
Driveway Enc. ;
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION.
I hereby affirm that I have a certificate of consent to self -insure,' or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
r WORKERS' COMPENSATION INSURANCE r
(Thin section need not be completed if the permit is for one hundred dollars ($100) valuation
' or less:)ce-
•'I •rtify that in the performance of the work for which this permit is issued, I shall not
employany
Laws of Californiaperson in any manner so as to become subject to the Workers' Compensation
TOTAL 1 2 1 I.
REMARKS '
inti LR RC`Ati'!_4 "TA674flzoi5
ate Owner
NOTICE TO APPLICANT: I/, alter making this Certificate of Exemption you should become
ZONE: -
- .' BY:. •=
subject to the Workers' Compensation provisions of the Labor Code; you must forthwith
comply with such provisions or this permit shall be deemed revoked. ..
Minimum Setback Distances:' '
- - ,
Front Setback from Center Line
- - -
Rear Setback from Rear Prop. Line -
CONSTRUCTION LENDING AGENCY.
Side Street Setback.frOm Center Line
hereby affirm that there is a construction lending agency for the performance of the
_work for which this permit is issued. (Sec..3097,.Civil Code.). ,.
Side Setback from. Property. Line - -
Lender's Name
_ X
Lender's Address
` '
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for. 180 days.
•I certify that I have read this application and state that the above information is correct..
Issued by:
Date - Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives 'of this city to enter the above.
>
mentioned property for inspection purposes.
Validated by:
-
Signature of applicant Date
" Mailing Address
Validation.
City, State, Zip
, i
y. y T ,y -! ..,' 'y- T „C ]A L Y - i+'r"T
• ,.-t i _ '. Y
:::
r - ' y i .'v • •%. ! V .` F i
•J..iJ
..:at ! }
' Y Sf}'f :-F'4 2''' 1• 4• t
'.' ce:i. F .y. =4
- S"ir .,.
•
Y rK _ Y'tf r+?
x . 14a " ' C+;iF 1, ! r .: +. xT'eA'". :4r .r , n -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. Ff.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. Ff. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1//. c
SEWAGE DISPOSAL
SO.Fi.GAR ® 3/ac
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE:d
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. (
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP,
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Building
Address
Owner
Mailing
Address ,
City Zip
'V n 'A•..: —A. • d1'
Cont
683€ 0" Ramon Road
y TT P_
Ica*_ Mtv
State Lic. ;
+8 Classif. ; +
',Arch: Engr.; '
tiDesigner
Address
Citv
CA
P.O. BOX 1504 N o
78-105CALLEESTADO. V916
old Fade LA QUINTA, CALIFORNIA 92253: ,` r
BUILDING: TYPE CONST. -OCC: GRP.
A.P. Number • ' * -
Tel.
I 6 R IA, Legal Description
Project Description + '
Tel.: (
lQ
22k- 60
City
Lic. # Al Sq. Ft. No. No. Dw.
Size Stories ' Units
el.
Zip State
• . - I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business'and Professions Code, and my licenseisin full force and
effect.
SIGNATURE! - ° ' DATE
OWNER -BUILDER DECLARATION
'I hereby affirm that I am exempt from the Contractor's License Law.for the following
reason: (Sec. 7031.5,Business and Professions- Code: Any city or .county which requires 'a
-f'S permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also
-,requires the applicant for such. permit to file a signed statement that he Is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
;for, the 1
;,subjects the applicanted rto a civil penalty ofviolation
not more thanSection
five h ndred by
dollars 'any
ant for a permit
0 I, as owner of the property, or rni employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code:. The Contractor's License Law does not.apply to an owner of property who
builds or improves• thereon and who does such work.himself orthrough his own employees,
provided that:sucnImprovements are.not intended or offered for sale. If,.however, the building
or Improvement is sold within one year of completion,the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a.contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec. - B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I'have a certificate of'consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
0 p is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
'WORKERS' COMPENSATION INSURANCE -
(This section need not be completed if the permit is for one hundred dollars ($100) valuation.
or less.) -
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
New ❑ Add:❑,
Alter ❑ Repair ❑ • Demolition ❑
' BY:
subject to the Workers' Compensation, provisions of the -Labor Code, you must forthwith-
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
n
_ _ _ - - - -
Front Setback from Center,Line
-•
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY • .
Side Street Setback from Center. Line
Estimated Valuation
xxxxtirM
2$..600
PERMIT
_ "
AMOUNT
Plan Chk. •Dep.
"Plan Chk. Bal.
FINAL DATE
i 9A A
Const.
_ in -
Mech.2A_
An '
Electrical
Issued by:
}A
Plumbing
'- .y
S.M.I.
I . ..
Grading
Validated by:
Driveway Enc.
Infrastructure
Validation:
City, State, Zip
i. `y L i Y'. +. t{t R,,, -`' SJ • 4r }.
; W
.+ r !t, E •, i s v ! 1 Sy .F•: I
T zi j i •iP f
:'. +n. .Y,. .. 1%">:. }`Y, ,-.i t J.. .., , .f.••- N . •M .`.,a..
Y* `F.'Y} •Yy •+:• i"R
. 1 •.
.t r. . 'f' ic
' -►. T iA.b' i;+d' " a+r7 e 4..
TOTAL
524:35 -
.5240`35 -
REMARKS
REMARKS
f'
• NOTICE TO APPLICANT: r if, after making this Certificate of Exemption you - should - become
ZONE:
' BY:
subject to the Workers' Compensation, provisions of the -Labor Code, you must forthwith-
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
n
_ _ _ - - - -
Front Setback from Center,Line
-•
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY • .
Side Street Setback from Center. Line
hereby affirm that there is a construction lending agency for the performance of.the
7- .work for which this permit is issued. (Sec. 3097, Civil code.) ., • , • ,
-
•Side Setback from. Property Line
:.Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
' This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above, information is correct.
Issued by:
Date ^ Permit '
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives 'of this city to enter the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
i. `y L i Y'. +. t{t R,,, -`' SJ • 4r }.
; W
.+ r !t, E •, i s v ! 1 Sy .F•: I
T zi j i •iP f
:'. +n. .Y,. .. 1%">:. }`Y, ,-.i t J.. .., , .f.••- N . •M .`.,a..
Y* `F.'Y} •Yy •+:• i"R
.y`-ia
J; ... Wl 5 .Y • j, ",i l'i r .'V... "•C t- l •_. .•:_
.
" • moi.. Rl
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. I SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WA1ER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE /
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP. l
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING 1 —31 Fi(
Lo
UNDERGROUND / (
A.C. UNIT
COLL. AREA
SLAB GRADE /
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS /
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINk
GAS (ROUGHI (- L
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEE
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. l
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FRAMING
FINAL INSP`3 /j -L!
C
ROOFING
_Xgg Q
U✓tL1T~
// ( G
4
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -L
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
4
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 4 _' Harigold La" LA QUINTA, CALIFORNIA 92253
Mailing
Address 43-'875 wasWmgt a 3t.
City P.D. JZ'p 92260 Tel.
Contractor
B.G. William Dev. Corp.
Address
ty
State Lic. Ql (City
& Classif. 493-19 Lic. # . 1231..
Arch., Engr.,
Designer
Address Tel.
City - Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7p00) of Division 3 of the Business and Professions Code, and my license is in full force and
e fecL
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S.Bushess and Professions Code: Any city or county which requires a
permit to cons truct; after, improve, demofish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the'Contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the 'exemption. exenpti. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chd penally of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such. improvements are not intended or offered for sale. If, however, the building
or improvement is soli within one year of completion, the owner -builder will have the burden
of proving that he did not buil or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con.
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec_ B. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy,No. Company
JO Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of Cali of=
Date Owner
NOTICE TO APPLICANT: H, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or rids permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 1110 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 05898
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number" '
Legal Description Ph"a 7T Tot 371
Project Description Plan IC Cactus Plover
Sq. Ft.
Size
No. No. Dw.
Stories Units
New dr Add ❑
Alter ❑ Repair ❑ Demolition ❑
Al
Estimated Valuation
73279.003
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
440.28
Const.
522.50
Mech.
53.50
Electrical
90.26
Plumbing
123.00
S.M.I.
5.13
Grading
Driveway Enc.
Infrastructure
lC48.78
TOTAL
• '' z'`- " r-t
REMARKS • .s .- - .- . r .fir . . .
}..,. r.1.. .!' R4a?t.6•T t '4 ;i's tit::.• .L..w' `i.,tJii.t, _rti = -
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property.Line
FINAL DATE INSPECTOR
6-15-89
Issued by- Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
i UNITS
SLAB GRADE 7Ji0
2ND FL Sp. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. I SO. FT.
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN.
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
ROOFING rj ¢ % s
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
rourc OIMAI
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11% c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE . PLUMBING . e ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBI G
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7Ji0
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. b! Z% OA
yr
001/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR. FINAL INSP. I Ol
FRAMING [ % i FINAL INSP. 3
ROOFING rj ¢ % s
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
rourc OIMAI
/
REMARKS:
INSPECTOR'S SIGNATURESHNITIALS
GARDEN WALL FINAL
•414Q
.'
P.O. BOX 1504 ✓ N o . 09228
Building 78-105 CALLE ESTADO
Address 44--435 Marig*ld LA QUINTA, CALIFORNIA 92253
Owner,
0..1i. Rices
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address game A.P. Number
City Zip Tel.
.La Ore lista 92253 360-3883 Legal Description
Contractor
Project Description
Address PATIO COVER
ity lZip I Tela
& Classif. 370055 B I Lic. #
Arch., Engr., `,
Designer
Address I Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
17000) of Division 3 of,thd Business and Professions Code, and my license is in full force and
e fect..
.R
SIONATURE a" +'v r x• - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 Dy 'any applicant for a permit
.subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's .License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or Improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con.
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.Company
O Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as .to become subject to the Workers' Compensation
Laws of California.
Date 0vf%?
NOTICE TO APPLICANT.: I, aRerlmaking -this Certificete'ol'Exemption'-jou should become
subject to the Workers' om. ition provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. 4
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agencyfor the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft.r35 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal %R SO
Const. 90 at)
Mech.
Electrical
Plumbing
S.M.I. l#Q
Grading
Driveway Enc. \
Infrastructure
TOTAL S
REMARKS
.•" laP.t :Z r FR RA . l :3 T R r . l'i''' R? . T :# V
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
FOR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SEWER OR SEPTIC TANK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
TEMP. POLE
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (RO'_U9)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRINGDU
ORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
cu. yd.
$ plus
x$ =$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREWINITIALS
GARDEN WALL FINAL